Reading Part B – RUM Bin

Part B 1

01. The guidelines says that the public:

1. Cannot directly deposit unwanted medicines in the RUM Bin;
2. Can directly deposit unwanted medicines in the RUM bin;
3. Can only see the RUM Bin to learn a message;

A RUM Project approved container (the RUM bin, or, Returned Unwanted Medicines Bin), lid and red seal is ordered and delivered by the preferred wholesaler to a community pharmacy on request. RUM bins are to be ordered only as required and stockpiling of RUM bins is discouraged. The RUM bin is to be kept in a section of the dispensary or in a room or enclosure in the pharmacy to which the public does not have access and is always under direct supervision of a pharmacist on duty. Ensure that the red seal is removed from base of the RUM bin and then the lid is firmly affixed to the base of the RUM bin before using. The RUM bin may be placed in a visible position, but out of reach of the public, as this will reinforce the message that unwanted medicines can be returned to the pharmacy for safe disposal but must always be in a position that the pharmacist can supervise and restrict access to the RUM bin.

Part B 2

02. According to the RUM Guidelines:

1. Some of the returned medicines can be of no use;
2. Most of the returned medicines can be of no use;
3. None of the returned medicines can be of use;

Any medicines returned by consumers must not be re-supplied to another patient. Returned medicines must not be re-used or recycled. Any medicines that are returned by consumers are not donated for overseas use as recommended by the Australian Guidelines for drug donation in developing countries (developed from the WHO Guidelines for Medicines Donations). Handling poisons is a professional responsibility, and whenever possible it is recommended that the pharmacist, or pharmacy graduate, accepts the returned medicines and places them in the RUM bin. When accepting unwanted medicines from consumers, pharmacists may take the opportunity to review the medicines returned, especially if the consumer is a regular customer, and thus determine if further consultation is required.

Part B 3

03. For the destruction of a schedule 8 medicine:

1. There should be at least one pharmacist present;
2. There should be 2 pharmacists present;
3. There should be at least two pharmacists and the customer present;

All medicines, including complementary and alternate medicines, received from consumers may be placed in the RUM bin, except for Schedule 8 medicines in some states. Schedule 8 medicines (pethidine, fentanyl, morphine oxycodone, methadone and buprenorphine) require special handling. It remains the responsibility of all pharmacists to ensure that they comply with their jurisdiction’s requirements for the disposal of Schedule 8 medicines. Pharmacists should take reasonable steps to ensure any Schedule 8 medicines returned for disposal are recorded and destroyed in accordance with Drugs, Poisons and Controlled Substances Regulations (VIC) 2017. Destruction of schedule 8 medicines can be performed by the pharmacist under the direct supervision of another pharmacist.

Part B 4

04. If the pharmacist cannot destroy a schedule 8 medicine:

1. It should not be placed in the RUM Bin;
2. It should undergo additional processing;
3. It should be destroyed completely;

When a Schedule 8 medicine is in a formulation that cannot be destroyed (i.e., the formulation is a tamper resistant formulation) it should be rendered unusable, unrecoverable and/or unidentifiable before being placed into the RUM bin. It is recommended if disposal kits (drug denaturing kits) with a neutralising agent are used they stored securely until denaturing is complete and then placed into the RUM bin.

Part B 5

05. According to the guidelines:

1. Sharps and needles can be kept in the RUM Bin after covering them in foils;
2. Tablets and capsules should be placed in the RUM without removing outer covering;
3. De-identification removes any details about the patient who used a particular medicine;

Pharmacists should remove the medicines from any outer packaging and place only the tablets or capsules (loose or in foils) into the RUM bin Any labelled packaging should then be de-identified in order to ensure the privacy of the patient is maintained before placing the packaging into the usual rubbish collection bins. Needles/ sharps should not be placed into the RUM bin. They should be disposed of using the appropriate sharps containers. Small quantities oral cytotoxic medicines (i.e., usual PBS prescription quantity) can be placed into the RUM bin.

Part B 6

06. The RUM guidelines emphasize that:

1. All medical waste should be deposited in the RUM Bin (only);
2. Not all medical waste need to be disposed of in the RUM Bin;
3. General rubbish bins are never to be used to collect any clinical waste;

Compounded chemotherapy treatments should not be placed into the RUM bin. These products should be disposed of in an appropriate cytotoxic waste container. Any Dose Administrations Aids returned for disposal should be placed into the RUM bin without any extraneous packaging – i.e., remove plastic sleeves, etc. Do not place any weekly organisers that are returned by consumers, in the RUM bin. These can be appropriately disposed of in the general rubbish once any medicines are removed from the organiser (medicines only placed in the RUM bin).

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